Method and apparatus for automated medical diagnosis using decision tree analysis

Abstract

An interactive method for performing a differential medical diagnosis utilizing a programmed computer system and a stored data base. In one particular embodiment, the method is for making a dermatopathological diagnosis based on operator selections from data files sequentially presented from the broadest scope to the narrowest scope. The data base is stored in a forwardly and backwardly linked hierarchical array of data files. If the data base were graphically arranged according to the linkages, it would appear in the form of a decision tree having a plurality of levels, each level encompassing the entire subject matter of dermatopathology. Each data file in the data base corresponds to a node of the decision tree and the records in the data file correspond to the branches.

We claim: 
     
       1. An interactive coomputerized system for performing a differential dermatopathological diagnosis of a biopsy based on characteristics of said biopsy product, said system comprising an output means for presenting a set of plurality of selected histopathological changes to an operator;   an input means for entering operator selected responses;   a memory means for storing a hierarchical data base, said data base comprised of a plurality of downwardly linked files, each file comprised of a header record and a plurality of data records, said operator selected response corresponding to one of said data records, said header record comprised of a file identification field and a field for containing the number of the data records located in the file, and each said data record comprised of a linking identifier field and a data field, said data field containing a histopathological change when said identifier field contains an entry of a file identifier that points to a data record located below in the hierarchy and containing a differential diagnosis when said identifier field does not contain said file identifier; and   processor means under a programmed control for receiving operator entered responses, for responding to the contents of the identifier field of said operator selected record for retrieving the linked file stored elsewhere in said memory means, and for providing the data stored in said linked file to said output means.   
     
     
       2. The interactive computerized differential diagnostic system as claimed in claim 1, wherein said header record of a present file also includes an antecedent linking identifier field for containing the identification of the file which had identified the present file. 
     
     
       3. The interactive computerized differential diagnostic system as claimed in claim 1, wherein said identifier field of a data record containing a differential diagnosis is empty; and wherein said processor means detects said empty field and provides an indication on said output means that the displayed data is diagnosis data. 
     
     
       4. The interactive computerized differential diagnostic system as claimed in claim 1, wherein said output means includes a printer; and wherein when said processor means detects that said indentifier field does not contain a file identifier, said processor means causes said printer to print a biopsy report containing the selected diagnostic changes and containing the differential diagnosis. 
     
     
       5. The interactive computerzied differential diagnostic system as claimed in claim 1, wherein said data record further includes a preferred diagnosis field which when filled contains the identification of a preferred diagnosis stored in said data field of the next downwardly linked file. 
     
     
       6. An interactive computerized system for performing a differential dermatopathological diagnosis of a biopsy based on characteristics of said biopsy product, said system comprising an output means for presenting a set of a plurality of selected histopathological changes to an operator;   an input means for entering operator selected responses;   a memory means for storing a hierarchical data base, said data base comprised of a plurality of downwardly linked files, each file comprised of a header record and a plurality of data records, said operator selected response corresponding to one of said data records, said header record comprised of a file identification field and each said data record comprised of a linking identifier field and a data field, said data field containing a histopathological change when said identifier field contains an entry of a file identifier that points to a data record located below in the hierarchy and containing a differential diagnosis when said identifier field does not contain said file identifier;   processor means under a programmed control for receiving operator entered responses, for responding to the contents of the identifier field of said operator selected record for retrieving the linked file stored elsewhere in said memory means, and for providing the data stored in said linked file to said output means; and   wherein said identifier field of a data record containing a differential diagnosis is empty and said processor means detects said empty field and provides an indication on said output means that the displayed data is diagnosis data.   
     
     
       7. The interactive computerized differential diagnostic system as claimed in claim 6, wherein said header record of a file also includes a field for containing the number of the data records located in the file. 
     
     
       8. The interactive computerzied differential diagnostic system as claimed in claim 6, wherein said header record of a present file also includes an antecedent linking identifier field for containing the identification of the file which had identified the present file. 
     
     
       9. The interactive computerized differential diagnostic system as claimed in claim 6, wherein said output means includes a printer; and wherein when said processor means detects that said identifier field does not contain a file identifier, said processor means causes said printer to print a biopsy report containing the selected diagnostic changes and containing the differential diagnosis. 
     
     
       10. The interactive computerized differential diagnostic system as claimed in claim 6, wherein said data record further includes a preferred diagnosis field which when filled contains the identification of a preferred diagnosis stored in said data field of the next downwardly linked file. 
     
     
       11. An interactive computerized system for performing a differential dermatopathological diagnosis of a biopsy based on characteristics of said biopsy product, said system comprising an output means for presenting a set of a plurality of selected histopathological changes to an operator;   an input means for entering operator selected responses;   a memory means for storing a hierarchical data base, said data base comprised of a plurality of downwardly linked files, each file comprised of a header record and a plurality of data records, said operator selected response corresponding to one of said data records, said header record comprised of a file identification field and each said data record comprised of a linking identifier field and a data field, said data field containing a histopathological change when said identifier field contains an entry of a file identifier that points to a data record located below in the hierarchy and containing a differential diagnosis when said identifier field does not contain said file identifier and said data field including a preferred diagnosis field which when filled contains the identification of a preferred diagnosis stored in said data field of the next downwardly linked file; and   processor means under a programmed control for receiving operator entered responses, for responding to the contents of the identifier field of said operator selected record for retrieving the linked file stored elsewhere in said memory means, and for providing the data stored in said linked file to said output means.   
     
     
       12. The interactive computerized differential diagnostic system as claimed in claim 11, wherein said header record of a present file also includes an antecedent linking identifier field for containing the identification of the file which had identified the present file. 
     
     
       13. The interactive computerized differential diagnostic system as claimed in claim 11, wherein said output means includes a printer; and wherein when said processor means detects that said identifier field does not contain a file identifier, said processor means causes said printer to print a biopsy report containing the selected diagnostic changes and containing the differential diagnosis.